The nurse is assessing a client suspected of having renal calculi who reports severe, wavelike pain that radiates down the thigh and to the genital area and a sensation of needing to void, but only small amounts are voided.
The nurse should explain which of the following information to the client?

"Stones that are lodged in the ureter cause symptoms like you are describing.”.

"You will most likely pass the stones in the next few hours.”.

"Your symptoms are consistent with stones that are lodged in the bladder.”.

"The stones will need to be removed through a procedure.”. .

Answer and Explanation

The Correct Answer is A

Choice A rationale

Ureteral stones cause severe, colicky pain that radiates to the groin or genital area. The ureter’s narrow anatomy can trap stones, causing obstruction. This obstruction triggers increased intrarenal pressure and ureteral spasms, producing waves of intense pain. Hematuria and urinary urgency with minimal voiding are common due to mucosal irritation or obstruction.

Choice B rationale

While small stones may pass spontaneously, predicting exact timelines is speculative. Passage depends on factors like stone size, location, and hydration. For stones larger than 5 mm, spontaneous passage rates decrease, often requiring intervention. Therefore, giving definite timeframes may misinform patients and delay appropriate care.

Choice C rationale

Bladder stones typically cause suprapubic pain, urinary frequency, and hematuria rather than radiating pain to the thigh or genital area. Bladder irritation may lead to dysuria or cloudy urine, but the described symptoms are more consistent with ureteral obstruction rather than bladder involvement.

Choice D rationale

Some stones do require procedural removal, especially those causing recurrent infections or obstruction. However, initial management includes conservative measures like hydration and pain control, reserving procedures for unresolvable cases. Early procedural focus may unnecessarily alarm the client or overlook noninvasive options.

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Correct Answer is B

Explanation

Choice A rationale

Magnesium levels and bilateral lower extremity ultrasounds are not specific for assessing target organ damage in hypertension. While magnesium may influence cardiovascular health, it is not a primary indicator of organ damage. Ultrasounds evaluate arterial or venous abnormalities, not hypertension’s systemic effects.

Choice B rationale

Urinalysis, blood chemistry, and a 12-lead electrocardiogram assess renal, metabolic, and cardiac effects of hypertension. Proteinuria in urinalysis indicates kidney damage. Electrolyte imbalances or creatinine elevations suggest renal impairment. An ECG reveals left ventricular hypertrophy or ischemia. These tests comprehensively evaluate hypertension-related complications.

Choice C rationale

A complete blood count evaluates blood cell counts but does not directly assess target organ damage from hypertension. An electroencephalogram assesses brain activity, not hypertension-induced injury. These tests are inappropriate for this diagnostic goal.

Choice D rationale

Troponin, calcium, and partial thromboplastin time evaluate myocardial infarction, bone health, and coagulation, respectively. They do not provide information about hypertension’s systemic organ effects. Accurate test selection ensures appropriate diagnostic focus.

A. Monitor the client for signs of hemorrhage. B. Monitor the incision site for signs of infection. C. Monitor the client's urine for sand or gravel. D. Monitor the percutaneous nephrostomy tube for signs of obstruction.

Correct Answer is C

Explanation

Choice A rationale

Hemorrhage is not a typical complication of extracorporeal shock wave lithotripsy (ESWL), as it is a non-invasive procedure targeting kidney stones using shock waves. The risk of significant bleeding is minimal, and monitoring focuses more on urinary changes or localized pain rather than hemorrhage.

Choice B rationale

ESWL does not involve surgical incisions, so there is no incision site to monitor for infection. This action is irrelevant to the procedure's mechanism, which uses external shock waves to fragment stones rather than invasive surgical methods.

Choice C rationale

Sand or gravel in the urine is a common finding after ESWL as the procedure fragments kidney stones into smaller particles. These fragments are excreted through the urinary system. Monitoring urine for these particles helps evaluate the procedure's effectiveness and ensure stones are adequately eliminated.

Choice D rationale

Percutaneous nephrostomy tubes are used for urinary drainage but are not a standard component of ESWL. Monitoring for tube obstruction applies to invasive procedures, whereas ESWL focuses on non-invasive stone fragmentation. This action is unrelated to the client's current treatment modality. .

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The nurse is assessing a client suspected of having renal calculi who reports severe, wavelike pain that radiates down the thigh and to the genital area and a sensation of needing to void, but only small amounts are voided.The nurse should explain which of the following information to the client?

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Naxlex Comprehensive Predictor Exams

The nurse is caring for a client with hypertension who is being assessed for possible target organ damage.The nurse should monitor the results of which of the following diagnostic tests?

Correct Answer is B

Explanation

The nurse is caring for a client after receiving extracorporeal shock wave lithotripsy (ESWL). Which of the following actions should the nurse take?

Correct Answer is C

Explanation

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The nurse is assessing a client suspected of having renal calculi who reports severe, wavelike pain that radiates down the thigh and to the genital area and a sensation of needing to void, but only small amounts are voided.
The nurse should explain which of the following information to the client?